The Massachusetts Homœopathic Hospital was not established for the special benefit of women, but in connection with the medical school of Boston University, but it received the funds of the old Female Medical School, and it has women professors and students, and admits women to the hospital as internes.

The hospitals have dispensaries connected with them which are very important aids to the work, both of charity and education. These dispensaries afford the students a wider range. of observation and experience than they could gain in the hospitals, since the patients are numbered by thousands, and they bring the poor sick women to the acquaintance of women physicians, to whom they can often confide their troubles more freely than to men. Cases which need the treatment of the hospital are secured admittance to it. In all this hospital work, and especially in that of the dispensary, as indeed in all charitable work, it has been found necessary to guard against the danger of pauperizing those who should be helped. For this reason a small charge is made to dispensary patients, except in cases of known destitution. The patients willingly pay it, feeling their own self-respect increased thereby, and the dispensary may be thus made nearly or quite self-supporting.

The surgical department of hospitals is of special importance to the poor, as it is almost impossible for them to have the conditions in their homes necessary to insure a fair chance of success and recovery in cases of operations. Remarkable success has been attained in this department in some of the hospitals I have named, where the greatest of abdominal operations are performed by surgeons connected with the hospital, with a percentage of recovery equal to that of other good hospitals here or in Europe. This branch of work is of absolute importance to the internes, and of the greatest value to the

nurses.

Not less interesting or successful is the maternity work of these hospitals. A great deal of the chronic trouble from which working women suffer so severely comes from want of proper care while they are exercising the functions of childbearing. The poor applicant to the maternity department is seen by the woman physician, who gives her advice as to previous care of herself, and she has in the hospital that thorough rest and care which are indispensable to full restoration to health.

A great moral question forces itself on the consideration of the managers of these hospitals. The applicants to the mater

nity are very often unmarried girls. Does true humanity require us to refuse help to such women? It is evident that care must be exercised to give no encouragement to immorality, while we must not refuse the aid which is so often absolutely necessary to save life. The problem is a difficult one, but the managers have tried to meet it. They usually make a distinction between the first offense-which is often rather due to weakness and folly than to depravity-and confirmed habits of immorality, and do not receive unmarried women a second time. In one hospital, at least, the directors find the greatest assistance from a committee of ladies who look after the maternity patients, both before they enter and after they leave the hospital. They endeavor to procure work for the mother, and watch over her welfare and that of the child. But they make it their invariable rule to give aid only on condition that the mother makes every effort to fulfill her maternal duties; for they believe there is a regenerating power in motherhood, and that care for her child is the surest safeguard against a mother's committing a second fault.

To many women of good position the maternity is a great blessing, if they have not comfortable homes and friends to care for them. The expense in the hospital is much less than the price for which good medical attendance and nursing can be secured at home.

I need only say of the medical care of women by their own sex in hospitals that its value has been fully proved. Women of all classes seek this aid eagerly, and show full confidence in their physicians and obey them quite as implicitly as they do those of the other sex. Women often say that they have suffered for years without medical or surgical assistance, that might have relieved them, from unwillingness to reveal their troubles to men. The greater freedom of the relation between patients and physicians of the same sex, enables the doctors to exercise much influence over their patients, who learn many good sanitary lessons in housekeeping. A physician was surprised to find the sick room of a poor patient carefully aired : Why, you know they always do so at the hospital," was the explanation given.

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These hospitals have also done much to dispel among the poor the fear of going to hospitals. Finding their friends

*

NOTE.-I do not mean to claim that this result, which is very evident in the community, is entirely due to the establishment of women's hospitals, for it is the consequence of a broader feeling for humanity in all institutions; but it is certainly a marked feature of women's hospitals. This note will apply

kindly ministered to by their own sex, they come to regard the hospital as a kindly refuge in sickness, not as the last resort of a homeless and deserted sufferer who will die unfriended and alone.

Besides these hospitals, especially adapted to assist in the medical education of women, are others established by women mainly in the interests of charity. I have, for instance, the twelfth annual report of "The Home of Mercy," in Pittsfield, Mass. It contains about thirteen beds, and the number of patients in a year was one hundred. It was established by a small body of women who felt the need of a place for the victims of accident or disease. Sixty-eight per cent. of the patients are women, and all the officers but the physicians. This institution seems to present a good model for smaller cities and towns where, especially among a manufacturing population, hospital accommodations are often much needed. A training school for nurses is added to its work.

Another step has been taken in the medical education of women in the employment of women physicians, (made obligatory by the Legislature in some States) in State institutions, thus giving them management of the women's infirmary. At the Reformatory prison at Sherburne, Mass., the resident physician has charge of the health of two hundred prisoners. The good care and treatment given them is apparent in the improvement of the health of prisoners during their stay, and in the small number of deaths.

The employment of women physicians in insane asylums is a very valuable measure from which we may hope great good in the future. At present, the most interesting instance of such work that has come to my notice is in the State Hospital for the Insane at Norristown, Pa., where Dr. Alice Bennett, with two women assistants, has charge of over eight hundred patients. Her carefully tabulated statistics throw much light on important questions regarding the causes of insanity and the probability of restoration. Dr. Bennett has introduced beneficial improvements in the treatment of patients in the direction of more freedom and more social life and opportunity of employment. She says in her last report, "No mechanical restraint (by which is meant enforced limitation of free movements of the body by means of jackets, muffs, straps, etc.) is at any time made use of in this department. There are

to all that I have said of hospitals. My subject is women's hospitals, but I would gladly do justice to the good work done in all hospitals, if it were not too broad a field.

times in the history of many cases, when temporary separation from external cause of irritation is beneficial and necessary

. . Brush making, basket making, sewing and mending, kindergarten occupations for the feebler-minded and melancholy, and the ever-present "house-work," in all its forms, engage about half the whole number of patients at one time or another. The officers and patients have also organized a 'Lend a Hand Club.' Dr. Bennett has arranged for a large number of patients to take their meals together, and finds the arrangement very beneficial."

Some of those who are working for the sick have preferred the name of "Hospital Association." Such is the St. Luke's hospital in Jacksonville, Fla., said to be the first one in the State. The officers are women, but the physicians and a board of trustees are men. The main purpose of this association seems to be to relieve the wants of strangers, who so often go to Florida seeking health, but sometimes in vain.

men.

The Women's Homœopathic Association of Pennsylvania was formed for a distinctively reformatory purpose. Its government is composed of women, with the exception of an advisory board of men. The medical faculty is composed of both men and women. This account is given of its origin : "The motive of starting a women's association was, largely, to correct the abuses that grow out of institutions managed by It is here now and has been for many years the custom for hospital or other charitable institutions to have an auxiliary board of women managers, whose duties are to look after the house-keeping department and raise money either by giving entertainments or begging-the expenditure of the money so raised, and general management of hospital work, is considered beyond a woman's ability. This prevents a voice in the higher administration. Some of the women, whose names appear as incorporators of the hospital of this association, desired to open an institution where women could, when in sickness and sorrow, be in the care of women. Out of 213 patients cared for during 1888, 153 were charity cases, 45 partial pay, and 15 cases full pay."

The "Philadelphia Home for Incurables" was established by women, but its bounty is not confined to them; it admits men as patients. With the exception of a superintendent of the men's department, the management is entirely in the hands of women. This is an effort to meet the crying need of a home for chronic sufferers. Each patient pays one hundred dollars and is kept during her life.

While

Much other work of the same nature as that I have described is, doubtless, doing in our vast country, of which no account has reached us. One of the many "Women's Clubs" has taken the subject of hospitals into serious consideration. rejoicing in every such effort, I would like to add a word of caution that every enterprise should be most carefully considered, and the work never allowed to fall below the recognized standard of merit.

When the pioneer hospitals were opened, no other clinical advantages were free to women; now the hospitals are beginning to open their doors to them. The report of the city hospital of Boston says, "The propriety of women practicing as physicians or surgeons, and their comparative ability and fitness to pursue this profession, are not questions for the trustees to consider in the official management of the hospital; they must recognize the fact that women are becoming practi tioners in all the schools of medicine; that they are admitted to the Massachusetts Medical and other State societies, and are recognized as practitioners by the community at large; and that they are admitted in common with male students to other leading hospitals of the country. The trustees therefore feel that there is no sufficient reason why women should not be admitted to the public instruction in the amphitheater on the same terms as men, except as to certain operations from which a reasonable sense or regard for propriety may exclude them." This advance in public opinion is most gratifying; but, even when all hospitals are open to women students, the value of those of which I have spoken will not be lost; they will still have special work to do, both in education and charity.

This movement for the clinical education of women in hospitals begun in America, has extended to Great Britain, Switzerland, and Germany, and is now being rapidly introduced into India, where the Women's Hospital is found to be a most important agent in educating and elevating the women of India.

The lamented Dr. Amandibai Joshee, who was the pioneer of medical education for Hindoo women, was a student at the Philadelphia college and an interne at the New England Hospital.

An excellent hospital in Burlington, Vt., was planned and endowed by a woman (Miss Mary Fletcher), who gave it her personal supervision. It had no direct bearing on women's education, but was open to all classes of patients. Since Miss Fletcher's death it is called by her name. It is mainly intended for residents of the State, although other patients are received if it is not full. It has no women physicians, but a board of